Department of Health and Social Care

Update on Screening

Lord Markham: My Hon. Friend Minister of State (Minister for Health and Secondary Care) (Andrew Stephenson) has made the the following Written Statement:I would like to inform the House that on Monday 4th March, NHS England wrote to a group of women who are at Very High Risk of breast cancer who have been eligible for annual MRI checks, but who may not have been routinely referred to the annual tests recommended in NHS guidance. This is an historic cohort of women who from 1962 to 2003 received radiotherapy treatment above the waist to treat Hodgkin lymphoma. Because of their treatment, this group were at an increased risk of breast cancer and therefore in 2003, clinicians were asked to contact both previous and current patients to refer them for annual checks. Women do not start annual MRI testing immediately following treatment – but between 8 and 15 years after treatment depending on their age at the time they were treated. A number of women who were eligible for more regular ‘annual’ testing did not receive it. This was due to variable referral processes. To rectify this, specialists set up a database to identify how people were referred onto the Very High Risk pathway for breast screening. Details of the missed group were shared with NHS England in late September 2023, and they have since analysed data to triangulate information about clinical history, current status and residency in order to identify the individuals in the affected cohorts. Ministers were notified in February 2024. We have overseen a system that has resulted in the identification of these very high risk women and now we are taking the appropriate action. This week, NHS England has written to 1487 women whom they have identified as not currently on the correct Very High-Risk pathway to receive annual MRI testing. This cohort will now be urgently offered an MRI follow up and inclusion in the Very High Risk pathway. We expect all women to be offered a scan within the next three months. The specialist team have also identified a much smaller historic group whose details are currently being verified and they will be written to in the coming weeks. NHS England has set up a helpline for affected women, the details of which will be included in letters sent to them. More widely, NHS England will undertake a review of the process that refers these women into the most appropriate service for their risk to mitigate any future impact of this issue. Further details of this issue can be found in a letter from NHSE to the DHSC Secretary of State which is attached to this statement and will be deposited in the Library.Letter from NHSE to DHSC SoS (pdf, 110.2KB)

NHS Workforce Update

Lord Markham: My Rt. Hon Friend the Secretary of State for Health and Social Care (Victoria Atkins MP) has made the following Written Statement:After re-entering negotiations with the British Medical Association (BMA) and Hospital Consultants and Specialists Association (HCSA) committees last month, during which the consultants did not take up industrial action, I am pleased to inform the House that I have made a revised formal offer to both unions, which includes a package of reforms to be applied from 1st March 2024. Both unions will recommend this revised offer to their members.   If accepted by their members, this would end the prospect of damaging strike action, benefit patients and deliver for consultants by delivering much needed reform. All sides returned to the negotiating table in good faith and in recognition of the narrow margin by which the initial offer rejected. I would like to thank the unions for their co-operation and willingness to come to a swift resolution. This demonstrates that approaching negotiations constructively and with reasonable expectations can lead to a good outcome for patients, consultants and the taxpayer.   The principles and aims of the updated offer remain the same. The Government’s position is that the headline pay uplift for 2023-24 was settled through the pay review body process. This updated offer adds further clarity and specificity, as well as addressing concerns that consultants have raised. The Government’s position remained that the headline pay uplift for 2023-24 was settled through the pay review body process. This is a reform offer. The core contract for consultants has not been updated for 20 years and this offer will deliver reform to reflect modern ways of working, such as enhanced shared parental leave, in line with other NHS staff. It invests in modernising the consultants’ pay structure – reducing the number of pay points and the time it takes to reach the top of the pay scale.As we originally proposed, this would make it faster for consultants to progress and help mitigate the gender pay gap which was expressly highlighted in the Independent Review into Gender Pay Gaps in Medicine in England. Under the revised offer, the government has agreed to include an uplift for consultants with 4 – 7 years of experience in direct response to members’ concerns. To enable these reforms, unions have agreed to end Local Clinical Excellence Awards (LCEAs) going forward – an employer level bonus scheme which has been seen to contribute to pay inequalities. The updated offer reaffirms our intention to introduce pay progression arrangements, which link pay progression and evidence of skills, competencies and experience, and further clarifies how this will work in practice. In addition, the Government will enact changes to the operation of the Review Body on Doctors’ and Dentists’ Remuneration (DDRB) to address matters raised by the BMA and HCSA. This offer sets out the detail of work to improve the process for the appointment of members to the DDRB, and revises the panel’s terms of reference. The Government has listened carefully to the concerns of consultants and their representatives, particularly around retention, motivation and morale. This revised offer has been carefully balanced to meet those concerns whilst also to ensure value for the taxpayer. This offer, should it be accepted, will improve the working lives of consultants whilst ending the prospect of damaging strike action that has had a detrimental impact on patients and the NHS. The BMA and HCSA will recommend this offer to their members in a vote in the coming weeks. No further industrial action will be called while this happens.

Department for Business and Trade

Update on 13th World Trade Organisation Ministerial Conference

Lord Johnson of Lainston: My Rt Hon Friend the Secretary of State for Business and Trade (Kemi Badenoch MP) has today made the following statement.Last week, I attended the World Trade Organisation’s 13th Ministerial Conference (MC13) in Abu Dhabi with the Minister of State for Trade Policy, my Rt Hon Friend, the Member for Chelsea and Fulham.MC13 saw the world’s Trade Ministers come together to discuss the most pressing challenges facing global trade and agree a way forward.The WTO Members agreed several outcomes, including:agreeing to extend the moratorium on customs duties on electronic transmissions, which protects tariff-free digital trade thereby maintaining lower costs and predictability for business engaging in digital trade;re-committing to find a solution to restore the dispute settlement impasse, which is necessary to uphold global rules of free, fair and open trade and to ensure that every Member of the WTO has access to a system to protect their trading interests against the unfair practices of other members;agreeing to extend the moratorium on TRIPS Non-Violation and Situation Complaints;agreeing a small package of outcomes on development, including easing the transition for countries graduating from ‘least developed country’ to ‘developed country’, such as Angola and Bangladesh;agreeing the Abu Dhabi Ministerial Declaration, which emphasises the importance of work on a range of important areas, including WTO reform, women's economic empowerment, services trade and supporting Micro, Small, and Medium Enterprises.MC13 also celebrated the accessions of two new Members to the WTO – Comoros and Timor-Leste – which will bring the total number of WTO Members up to 166 and help developing countries reap the benefits of free trade.At the conference, we celebrated the entry into force of new disciplines under the Services Domestic Regulation Joint Initiative, which could lead to global savings of £99 billion through facilitating trade in services.The UK is also pleased to have completed the Investment Facilitation for Development Agreement, which commits its 127 signatories to practical steps to make it easier to invest in developing countries. This means UK investors should benefit from reduced transaction costs in low-income countries under this Agreement, which could increase stocks of outward UK FDI by £2.5 billion in participating Members. The Agreement will also cut red tape, providing one-stop-shop for investors to communicate with government, and the creation of a single website investors can go to for information.The UK remains committed to the rules-based multilateral trading system as vital to economic prosperity and trading stability for all its 166 Members. MC13 did not deliver on all of the UK’s objectives and was a stark reminder of the challenge of agreeing change on the consensus basis of the WTO. However, the WTO remains a critical, albeit imperfect, part of the global trading system that helps deliver global economic growth.MC13 was also a great opportunity to meet with my international counterparts, including the Gulf Cooperation Council, United States Trade Representative and EU Executive Vice-President to progress MC13 negotiations, the New Zealand and Australian Trade Ministers to discuss implementation of the UK’s Free Trade Agreements, and the Canadian Trade Minister to discuss bilateral trade relations, including Rules of Origin.

Department for Environment, Food and Rural Affairs

Fairer regulation of farming

Lord Douglas-Miller: My Right Honourable friend the Secretary of State for Environment, Food and Rural Affairs (Steve Barclay) has made the following Statement.In June 2023, the Government launched a consultation on how hedgerows should be protected in England. The consultation asked for views on the Government’s proposals to maintain protections for hedgerows by bringing management rules into domestic legislation. These rules included maintaining green cover 2 metres from the centre of a hedgerow, prohibiting hedge cutting between March 1 and August 31 and the relevant exemptions related to these rules. The consultation also proposed a suite of civil sanctions that could be used to address non-compliance with the rules as part of a proportionate, supportive regime. Hedgerows are an important part of our countryside and have many important benefits for our wildlife and environment as well as their contribution to the landscape. Although this consultation asked specifically about protecting hedgerows on agricultural land, we also asked where the government should focus its ambitions for future hedgerows policy. Responses to this question showed strong support for extending protections outside of agricultural land as all hedgerows are important havens for wildlife. The government will continue to consider how best to support the sustainable management and protection of hedgerows in different contexts, taking account of the views expressed through this consultation.  We know that our farmers and land managers value our hedgerows. There are now over 90,000km of hedgerows with one or both sides being managed under 16,000 Countryside Stewardship and SFI agreements in England. Through Countryside Stewardship capital grants over 13,000km of hedgerows have been created or restored. We received 8,841 responses to the consultation, which closed in September 2023. We considered all the responses carefully and have today published the government response to the consultation on Gov.uk.There was overwhelming support for hedgerow management measures to come into legislation, and we will now bring forward secondary legislation setting these out as soon as possible to ensure that these important protections are in place quickly. We trust our farmers to look after hedgerows and the new legislation will provide the reassurance that all are following the same management approach. Alongside the continuation of our hedgerow offers in our Environmental Land Management schemes this will underline a commitment to protecting hedgerows and supporting those who look after them. The legislation will maintain the same level of protections as previous cross compliance rules did, but our approach to enforcement of the proposed new regulation will be different, with a focus on being fair and proportionate. We have learned lessons from previous approaches, and believe an advice led approach will result in the best outcomes. We will be talking to farmers and environmental organisations about this, as well as consulting as required in the Regulatory Enforcement and Sanctions Act 2008.